Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. NICOLE JOSETTE BOARDMAN MITCHAM MD, MPH
NPI 1154016533
Internal Medicine in Phoenix, AZ

Q: What is Nicole Boardman Mitcham's NPI number?

The NPI number for Nicole Boardman Mitcham is 1154016533. It was assigned to this individual provider in the NPPES registry on April 10, 2023.

Q: What is Nicole Boardman Mitcham's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since April 10, 2023PECOS Enrolled

2525 E ROOSEVELT ST, PHOENIX, AZ 85008(833) 855-9973 Get Directions Write a Review

NPPES record last updated: September 1, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 1, 2026, Nov 4, 2024, Apr 10, 2023 (3 updates tracked since 2023).

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About Dr. Nicole Josette Boardman Mitcham Md, Mph NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICOLE JOSETTE BOARDMAN MITCHAM MD, MPH (NPI 1154016533) is an individual internal medicine provider in Phoenix, Arizona, licensed in Arizona (79944) and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Phoenix, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1154016533

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameDR. NICOLE JOSETTE BOARDMAN MITCHAMCredential: MD, MPH

Location Address2525 E ROOSEVELT STPhoenix, AZ 85008-4948

Mailing Address8088 W Whitney DrPeoria, AZ 85345-6564

Phone(833) 855-9973

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateApril 10, 2023

Last NPPES UpdateSeptember 1, 20263 updates tracked since enumeration

NPPES CertifiedSeptember 1, 2026

✔ NPI 1154016533 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in AZ · 79944

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

2525 E ROOSEVELT ST, Phoenix, AZ 85008

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Secondary Practice Location 1

Location 12601 E Roosevelt StPhoenix, AZ 85008-4973 · Phone (602) 344-5011

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicole Josette Boardman Mitcham Md, Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8022476365

PECOS Enrollment IDI20260730002104

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Nicole Boardman Mitcham reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

District Medical Group, Inc

Same address

Pulmonary Disease

2525 E ROOSEVELT ST, MED CLINIC - PULMONARY
Phoenix, AZ 85008

Reassigned Medicare billing, Arizona enrollment
1,490 clinicians in this Medicare group

NPI 1700119815 (602) 344-1095

Maricopa County Special Health Care District

0.1 mi

Adult Mental Health

2525 E ROOSEVELT ST
Phoenix, AZ 85008

Reassigned Medicare billing, Arizona enrollment
285 clinicians in this Medicare group

NPI 1205295581 (602) 344-8178

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85008 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$127.71 typical visit price

range $55.44 – $168.60

Typical copayment $31.92 (range $13.86 – $42.15)

Most-billed visit code 99204

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT

Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)